Individual
BERKELEY VANDYKE CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
474 LYTLE AVE SE, ATLANTA, GA 30316-1510
(904) 315-3896
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0134281
VT
225100000X
Physical Therapist
048415-01
NY
225100000X
Physical Therapist
05014519A
IN
225100000X
Physical Therapist
15718-24
WI
225100000X
Physical Therapist
Primary
PT013456
GA
225100000X
Physical Therapist
PT019545
OH
225100000X
Physical Therapist
PT030293
PA
225100000X
Physical Therapist
PT200001193
DC
225100000X
Physical Therapist
PT5928
ME
Other
Enumeration date
12/30/2017
Last updated
03/31/2022
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